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The present study aimed to examine the comorbidity among symptoms of internet gaming disorder (IGD), social withdrawal, and depression using the network perspective. An online survey recruited 3430 young people in Hong Kong (mean age = 19.4 years, 80.5 % male) via gaming channels in 2019. The participants completed the 9-item IGD Scale, Hikikomori Questionnaire, and Patient Health Questionnaire-9. Network analysis was conducted using R to estimate the central symptoms of IGD and depression in individual networks and identified the bridge symptoms in combined network of IGD, social withdrawal, and depressive symptoms. All network models showed high stability. 'Withdrawal', 'Loss of control', and ' Tolerance ' were the central IGD symptoms, while ' Depressed mood ' and ' Self-blame/guilt ' were the central depressive symptoms. The bridge symptoms were ' Gaming as escape or mood relief ' from IGD cluster, ' Depressed mood ' and ' Self-blame/guilt ' from depression cluster, and ' Marked social isolation at home ' and ' Significant distress due to social isolation ' from social withdrawal cluster. The combined network showed no significant differences in network structure and global strength across gender and age groups. The cross-sectional sample only indicated undirected associations between the symptoms in the three clusters and could not model the intra-individual variation. The present study provided the first results on the comorbidity among IGD, social withdrawal, and depression at a symptom level among Chinese young people via network analysis. The bridge symptoms highlight potential targets for interventions of comorbidity among the disorders. • We examined comorbidity among IGD, hikikomori, and PHQ-9 in 3430 Chinese young people. • Network analysis found 'Withdrawal' and 'Tolerance' as the central IGD symptoms. • 'Gaming as escape or mood relief' was the bridge symptom for IGD in combined network. • 'Depressed mood' and 'Self-blame/guilt' are central and bridge symptoms for PHQ-9. • We identified the bridge symptoms as potential targets of interventions among gamers. [ABSTRACT FROM AUTHOR]

The study was designed to investigate the associations between social withdrawal, emotional symptoms, and suicide ideation in patients with major depressive disorder (MDD). This cross-sectional study included 2678 MDD patients from the National Survey on Symptomatology of Depression (NSSD). Differences in the sociodemographic factors, clinical characteristics, suicide ideation, and emotional symptoms were compared in patients with different frequencies of social withdrawal. Pearson correlation, multiple linear regression analysis, and mediation analysis were employed to assess the contribution of social withdrawal to suicide ideation. MDD patients with a higher frequency of social withdrawal were prone to have a higher frequency of suicide ideation (p for trend <0.001) and history of suicide behavior (p for trend <0.001). Multiple linear regression analysis showed that there was a dose–response relationship between social withdrawal and suicide ideation in MDD patients, but this association became insignificant after adjusting for emotional symptoms. Mediation analysis suggested that all of the emotional symptoms had significant mediating effects on the association between social withdrawal and suicide ideation in MDD patients (p < 0.05). The magnitude of mediation varied between 4.3 % and 64.3 %, with the largest mediating effect in the feeling of despair (64.3 %), helplessness (41.2 %), and loneliness (40.0 %). Our study provides evidence that social withdrawal was a common clinical presentation and it may increase the risk for suicide through emotional symptoms in MDD patients. Causal conclusions could not be drawn between social withdrawal, emotional symptoms, and suicide ideation because of the cross-sectional design of the study. • ≥ 60% of the major depressive disorder (MDD) patients had remarkable social withdrawal. • Social withdrawal was postively associated with suicide ideation and history of suicide behavior in MDD patients. • Emotional symptoms mediated the associations between social withdrawal and suicide ideation. [ABSTRACT FROM AUTHOR]

This study explores the correlation between spiritual well-being and game addiction among Chinese youths in Hong Kong. To examine such a relationship, cross-sectional data (N = 401) were taken from a sample of 209 Chinese university students in 2021 and 192 Chinese university students in 2022. They are between 18–21 years old. The participants answered the Spiritual Well-being Questionnaire to gauge their spiritual well-being in the personal-communal, environmental and transcendental domains. Then, the respondents accomplished the Game Addiction Scale 21 to assess the extent of their gaming use in seven dimensions, namely, salience, tolerance, mood modification, relapse, withdrawal, conflict and problems of game addiction. The study revealed a negative correlation between the three domains of spiritual well-being and the seven dimensions of game addiction. Moreover, multiple regression analysis showed that the personal-communal and environmental domains of spiritual well-being accounted for 59.0% and 10% of the variance in students' overall game addiction, respectively. The personal-communal domain was found to be the strongest predictor of game addiction. As an effective preventive strategy and treatment, the spiritual well-being and health of adolescents should be enhanced. [ABSTRACT FROM AUTHOR]

Smartphones have arguably become a common necessity in modern society. While they can be used for many practical purposes, their many features increase the risk of overuse, a key element in behavioral addiction. The present study examined withdrawal-related scores on the Smartphone Withdrawal Scale, the Fear of Missing Out Scale, and the Positive and Negative Affect Schedule during a smartphone restriction period, lasting 72 h. In total, 127 participants were randomly assigned either to a condition without smartphone access or to a control condition. The scales were administered three times a day during the restriction period and smartphone addiction scores were assessed on Day 1. The results showed that participants with the highest scores on smartphone addiction in the restricted condition were significantly more negatively affected by the restriction (compared to those with lower scores). This appears to indicate that being restricted from using smartphones can generate significant withdrawal symptoms, especially for those at risk of smartphone addiction. Plain Language Summary: Smartphones have arguably become a common necessity in modern society. While it can be used for many practical purposes, its many features increase the risk of overuse, a key element in behavioural addiction. The present study examined withdrawal-related symptoms during a smartphone restriction period, lasting 72 hours. The participants were divided in to two groups where one group was without access to their smartphone, while the other group was allowed to keep their smartphone and use it as they normally would. All participants had to complete a number of questionnaires that were administered three times a day during the restriction period and smartphone addiction scores were assessed on Day 1. The results showed that participants with the highest scores on smartphone addiction in the restricted group were significantly more negatively affected by the restriction (compared to those with lower scores). This appears to indicate that being restricted from using smartphones can cause significant withdrawal symptoms, especially for those at risk of smartphone addiction. [ABSTRACT FROM AUTHOR]

Adolescent loneliness can have detrimental effects on physical and mental health, but there is limited understanding of its antecedents in infancy and childhood. A 20‐year longitudinal, multi‐informant, and multi‐methods study (first data collection in 1998) was conducted to examine mechanisms underlying adolescent loneliness (N = 128, 52% boys, Mage_baseline = 1.23, SD = 0.02, 99% White, recruitment in Dutch urban, healthcare centers). Structural equation modeling showed that high infant behavioral inhibition (BI) was indirectly associated with high loneliness during adolescence via high childhood social withdrawal. This indirect effect was equally strong during early, middle, and late adolescence. Contrary to expectations, infant parenting did not moderate the relation between BI and social withdrawal. The results suggest a developmental cascade with infant BI showing long‐lasting indirect effects on adolescent loneliness up to 20 years later via childhood social withdrawal. [ABSTRACT FROM AUTHOR]

We assessed the psychometric properties of the Social Behavior Questionnaire (SBQ), a 30-item questionnaire evaluating social (e.g., disruptive behaviors, bullying) and emotional problems (e.g., anxiety, depression) among children aged 3.5–12 years. Children (n = 1,950, 50.21% boys) were drawn from the Quebec Longitudinal Study of Child Development. Mothers reported the frequency with which children presented social and emotional behaviors from 3.5 to 8 years of age, and teachers from 6 to 12 years. We assessed internal structure using Confirmatory Factor Analysis, reliability using Cronbach's alpha, and convergent and discriminant validity using a multitrait-multimethod (MTMM) approach. The six-factor (emotional distress, withdrawal, impulsive/hyperactive/inattentive, disruptive behaviors, prosocial behaviors, and peer relationships difficulties) structure of the SBQ showed good fit from ages 3.5 to 12 years. Reliability estimates were good to excellent (alphas >.7), and MTMM showed good convergent and discriminant validity. Overall, the SBQ presented good psychometric properties with a large population-based sample aged 3.5–12 years. Further studies should assess its screening potential by investigating its convergent validity with diagnostic information. [ABSTRACT FROM AUTHOR]

Social withdrawal in patients with depression can aggravate depressive symptoms. However, few studies focus on the behavioral changes of social isolation after CUMS. NRF2 had been reported to be down-regulated after CUMS. But whether NRF2 participates in behavioral changes induced by social isolation after CUMS remains unclear. This study aims to develop a new model combined social isolation with CUMS, and investigate whether such behavioral changes are related to NRF2 signaling. This study included two stages. In Stage 1, rats were subjected to 4-week CUMS and CUMS-susceptible rats were selected. In Stage 2, the CUMS-susceptible rats received 4-week social isolation or social support. Behavioral tests were carried out to observe behavioral changes, including sucrose preference test, forced swimming test, open field test, novel object recognition and social interaction test. QRT-PCR, western blot and immunofluorescence staining detected the ERK/KEAP1/NRF2 signaling. CUMS-susceptible rats exhibited depressive-like behaviors accompanied by the down-regulated ERK/KEAP1/NRF2 signaling in hippocampus. In Stage 2, compared with 4-week social support (group CUMSG), 4-week social isolation (group CUMSI) perpetuated the depressive-like behaviors, memory deficits and social withdrawal in CUMS-susceptible rats, as well as lower levels of p-ERK, NRF2, p-NRF2, HO-1 and NQO1, and the higher levels of KEAP1 in hippocampus. These findings suggested that social isolation after CUMS perpetuated depressive-like behaviors, memory deficits and social withdrawal via inhibiting ERK/KEAP1/NRF2 signaling. This study provided molecular evidence for the effects of post-stress social isolation on mental health, and the antioxidant stress signaling might be a target to rescue these. • A new model combined CUMS and social isolation was successfully developed. • Social isolation after CUMS resulted in the persistence of depressive-like behaviors, memory deficits and social withdrawal in CUMS-susceptible rats. • The behavioral changes might be due to inhibition of ERK/KEAP1/NRF2 signaling. [ABSTRACT FROM AUTHOR]

The purpose of this 5‐year longitudinal study is to identify trajectories of team and individual sports participation in childhood, and to compare these trajectories on different types of internalizing problems. Parents reported their children's annual sports participation from the ages of 6–10 (n = 785) and teachers reported internalizing problems (depression, anxiety, social withdrawal) at the beginning and at the end of this period. The study used latent class growth analyses to identify two trajectories of team sports and two trajectories of individual sports participation were identified: (1) high participation, and (2) low participation. Considering baseline level of internalizing problems and gender, children in the high participation team sports trajectory show significantly fewer depression, anxiety, and social withdrawal behaviors at age 10 than those in the low participation team sports trajectory. No differences between individual sports trajectories were observed. Comparison with joint trajectory groups partially confirmed these results but also showed that sustained participation in multiple individual sports could also be linked to decreased anxiety. Our findings suggest that participation in team sports should be encouraged to promote certain aspects of children's mental health. [ABSTRACT FROM AUTHOR]

Myocardial infarction (MI) is one of the leading causes of mortality and disability worldwide. Emotional distress, such as anxiety and depression, are common among MI patients. The aim of this study was to investigate emotional reactions following MI and to explore how MI patients self-manage their emotional distress using the perspective of an explanatory behavioural model of depression and anxiety. Written testimonies from 92 MI patients starting an internet-based cognitive behavioural therapy (iCBT) were analysed using qualitative content analysis with a mixed deductive and inductive approach. Six themes were identified. The first three highlight the emotional reactions post-MI: Hypoarousal reactions and low mood; Hyperarousal reactions; and A changed sense of self and outlook on life. The following three themes describe strategies for managing emotional distress: Avoidance of potentially rewarding situations; Avoidance of heart relevant stimuli triggering anxiety; and Engaging in potentially positive activities and acceptance. The MI experience may trigger emotional reactions, with a particular emphasis on heart-focused anxiety, depression and a shift in the perception of one's identity. Patients tend to manage emotional distress through social withdrawal and experiential avoidance which likely maintains the distress. Applying a behavioural model to the management of emotional distress following MI is suited. [ABSTRACT FROM AUTHOR]

Affective disorders including depression (characterized by reduced motivation, social withdrawal, and anhedonia), anxiety, and irritability are frequently reported as long-term consequences of mild traumatic brain injury (mTBI) in addition to cognitive deficits, suggesting a possible dysregulation within mood/motivational neural circuits. One of the important brain regions that control motivation and mood is the lateral habenula (LHb), whose hyperactivity is associated with depression. Here, we used a repetitive closed-head injury mTBI model that is associated with social deficits in adult male mice and explored the possible long-term alterations in LHb activity and motivated behavior 10-18 days post-injury. We found that mTBI increased the proportion of spontaneous tonically active LHb neurons yet decreased the proportion of LHb neurons displaying bursting activity. Additionally, mTBI diminished spontaneous glutamatergic and GABAergic synaptic activity onto LHb neurons, while synaptic excitation and inhibition (E/I) balance was shifted toward excitation through a greater suppression of GABAergic transmission. Behaviorally, mTBI increased the latency in grooming behavior in the sucrose splash test suggesting reduced self-care motivated behavior following mTBI. To show whether limiting LHb hyperactivity could restore motivational deficits in grooming behavior, we then tested the effects of Gi (hM4Di)-DREADD-mediated inhibition of LHb activity in the sucrose splash test. We found that chemogenetic inhibition of LHb glutamatergic neurons was sufficient to reverse mTBI-induced delays in grooming behavior. Overall, our study provides the first evidence for persistent LHb neuronal dysfunction due to an altered synaptic integration as causal neural correlates of dysregulated motivational states by mTBI. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the prevalence and severity of emotional and behavioural problems among adolescents. STUDY DESIGN: Cross-sectional study PLACE AND DURATION OF STUDY: The study was conducted at private sector secondary schools of Karachi, from August 2021-February 2022. SUBJECTS AND METHODS: The sample comprised 1470 students between the ages of 11 to 17 years from different private sector secondary schools in Karachi. The sample was collected through a convenience sampling technique. Socio-demographic Information Form, Asian Adolescents Depression Scale (AADS) and School Children Problem Scale (SCPS) were used. SPSS 26 was used to analyse the data. RESULTS: The mean age of study respondents was 13.62 years (SD 1.39). Findings of the present study reveal that emotional and behavioural problems were more common among female adolescents as compared to their male counterparts. Overall, all 20% of study respondents were found to have very severe level of emotional and behavioural problems, and aggression was the most common problem among 14% of adolescents, followed by academic problems in 9.7% of adolescents. Approximately 20% of the school going adolescents were struggling with emotional and behavioural problems (i.e., anxiousness, aggression, social withdrawal, rejection, somatic problems, & depression), along with academic problems. Further, a statistically significant association was found between gender, emotional and behavioural problems. Mental health experts should focus on prevention and treatment interventions in school settings to reduce the risk of emotional and behavioural problems of Pakistani adolescents so that they could grow socially and emotionally healthy and excel in their academics and contribute to their family and community. CONCLUSION: Adolescence is a growing age, during this phase individual can experience social and emotional issues. Detecting these issues at early stage could reduce the risk of mental health problems at later stage. Mental health experts should focus on prevention and treatment interventions in school settings to reduce the risk of emotional and behavioral problems of Pakistani adolescents so that they could grow socially and emotionally healthy and excel in their academics and contribute to their family and community. [ABSTRACT FROM AUTHOR]

This article investigates children's everyday manifestations of grief and grieving situations. Medical and psychological approaches to grief and grieving usually focus on the death of loved ones. It is argued that everyday grief and grieving in early childhood education and care (ECEC) is present in social situations where loneliness and withdrawal are experienced by children. A cultural–historical approach was used to examine everyday grief and grieving in the preschool setting. Video observations were made of Mayra, a 5-year-old girl living in a rural Mexican community. The findings show that grief and grieving are affected by children's social situations, the material conditions of the location and the adult's role in compassionate approach in alleviating grief. Implications from this study highlight the need to examine everyday situations where children experience loneliness and withdrawal when relating to peers as a part of children's larger frame of grief. [ABSTRACT FROM AUTHOR]

Siblings play an important role in the behavioral trajectories of individuals with autism spectrum disorder (ASD). While having siblings has been associated with positive outcomes in ASD, including stronger adaptive functioning, social and non-verbal communication, and theory of mind, little is known about the impact of siblings on more negative outcomes, such as maladaptive behaviors. To address this gap, the present longitudinal study tested sibling predictors of trajectories of maladaptive behaviors (e.g., teacher- and parent-reported hyperactivity, irritability, and social withdrawal) from childhood through early adulthood among individuals with ASD and non-spectrum delays. Multilevel models revealed that, while the mere presence of a sibling did not impact maladaptive behavior trajectories apart from teacher-reported hyperactivity, the diagnostic profile of the sibling (e.g., emotional/behavioral disorder, ASD, medical condition) emerged as an important predictor. Specifically, although findings varied across teacher and parent reports, more hyperactivity and irritability across time was identified when the sibling had diagnoses of an emotional/behavioral disorder, ASD, and/or a medical condition. Overall, this study provides novel insight into the broader family-level factors that influence the presentation of maladaptive behaviors across time and across contexts. [ABSTRACT FROM AUTHOR]

An evolving concept in recovery from mental illness dwells on the patients' perspectives towards attainment of life goals despite incomplete remission. The study aims to explore the level of recovery attitude and the possible association with socio-demographic and clinical variables. Two hundred and eighty two male and female patients' with schizophrenia were interviewed using structured instruments: Recovery Attitude Questionnaire (RAQ), Brief Psychiatric Rating Scale (BPRS), Oslo 3 Social Support Scale, Morisky Medication adherence Scale (MMAS) and Simpson and Angus Scale (SAS). Chi square analysis was used to assess for the correlates of recovery attitude and variables with significant associations were subjected to binary logistic regression analysis. Two hundred and forty two (85.8%) of the participants had positive recovery attitude and the correlates of positive recovery attitude were: being employed (χ² = 5.702; p = 0.017), duration of illness less than one year (χ² = 7.947; p = 0.047), nil hospital admission (χ² = 10.75; p = 0.013), nil history of relapse (χ² = 6.307; p = 0.012), normal to minimally ill on BPRS (χ² =18.20; p = 0.000), high social support (χ² = 44.72; p = 0.000) and low stigma on discrimination (χ2 = 8.173; p = 0.004), social withdrawal (χ² (χ² = 33.36; p = 0.000). The study revealed a high level of positive recovery attitude among patients with schizophrenia with high social support being the greatest independent predictor of recovery attitude. The outcome of this study therefore draws attention to the potential benefit of programmes that strengthen the social network as well as hope inspiring activities to enhance recovery. [ABSTRACT FROM AUTHOR]

This study aimed to test a serial mediation model proposing that prematurity would be related to changes in maternal emotional distress, which in turn would be related to the mother–child (M-C) interaction, which would ultimately be related to infant social withdrawal. Bedouin mothers and their preterm (n = 48) and full-term (n = 57) infants participated in this study. Mothers' mean age was 27.67 years. In addition, 39.4% of the mothers were primiparas and 60.6% were multiparas. Infants and their mothers were recruited shortly after birth (T1) in the maternity ward or Neonatal Intensive Care Unit (NICU) at Soroka Medical Center and were followed up at ages 6 months (T2) and 12 months (T3). Findings indicated that HIGHER levels of maternal emotional distress during the second half of the first year postpartum and LOWER levels of mother–child interaction, were associated with HIGHER levels of infant social withdrawal at T3. Furthermore, the overall indirect effect suggested that HIGHER levels of maternal nonhostility was a main variable mediating the link between prematurity and LOW levels of infant social withdrawal. Our findings provide evidence that changes in maternal emotional distress during the first year are related to lower infant social withdrawal. Moreover, mothers of premature infants showed higher levels of nonhostility when interacting with their premature infants. These findings highlight the importance of gaining a better understanding of maternal behaviors. Specifically, our study provides important information for researchers and clinicians on a possible mechanism leading to early socioemotional difficulties of premature infants. [ABSTRACT FROM AUTHOR]

Objective: Although past research has shown the negative consequences of state inauthenticity (i.e., the experience of inauthenticity), what triggers state inauthenticity remains to be better understood. We focus on leader Machiavellianism (Mach), defined as the extent to which leaders engage in unethical and manipulative behaviors to attain their goals, as a predictor of follower state inauthenticity. Drawing on the social misfit argument, we examined a model in which leader Mach, jointly with a perceived collectivistic work climate, determines follower state inauthenticity and subsequent work withdrawal. Method: We used a vignette‐based lab study (303 participants from the United States) and a daily diary field study (476 daily responses from 69 participants recruited from China). Results: Across two studies, we found that follower state inauthenticity mediated the relationship between leader Mach and follower work withdrawal. The positive relationship between leader Mach and follower state inauthenticity was strengthened by a perceived collectivistic work climate. Conclusions: The present research underlines the importance of the social environment in influencing follower state inauthenticity at work and shifts research attention from the consequences of state inauthenticity to its predictors. [ABSTRACT FROM AUTHOR]

This study examined the conditions for, and mechanisms of, mentoring efficacy against depression symptoms in a random sample of 202 adolescent North Korean refugees living in South Korea. Rhodes (2005) argued that mentoring may benefit adolescents with high parental attachment because social engagement comes easily to them, and that it also may benefit adolescents with weak attachment because of greater need. The present study drew on Rhodes' (2005) theory to postulate curvilinear moderation of the mentoring-depression relationship by parental attachment. Teacher and peer attachment were posited as mediators of the relationship between mentoring and depression. Using fixed effects regression models, Sobel tests, and non-parametric bootstraps to test the hypotheses, a negative association was identified between mentoring and depression symptoms. Results suggested mediation by social withdrawal, and models also found a significant curvilinear moderating effect of parental attachment on the mentoring-depression relationship. These findings suggest that adolescent North Korean refugees with strong parental attachment and adolescent North Korean refugees with weak parental attachment may disproportionately benefit from mentoring as compared with adolescent North Korean refugees who scored in the middle in parental attachment. These results are also consistent with the idea that mentoring may reduce social withdrawal which, in turn, reduces depression. [ABSTRACT FROM AUTHOR]

Objective: Long-lasting care process can result in the withdrawal of the mother with children diagnosed with cerebral palsy (CP) from the social environment and cultural activities while leading also to physical exhaustion. The present study evaluates the levels of depression and anxiety, suicidal ideation, and behaviors in mothers with children diagnosed with CP. Methods: The study included 57 healthy mothers with children aged 2-16 years who have been diagnosed with CP and 41 healthy mothers with healthy children as a control group. The Hospital Anxiety and Depression Scale (HADS), the Scale for Suicidal Ideation (SSI), and the Suicidal Behavior Scale (SBS) were administered to all participants. Results: The sociodemographic status of the mothers of children with CP was similar to that of the mothers with healthy children (p>0.05). The HADS, SSI, and SBS scores were found to be higher in the mothers with children with a CP diagnosis than in mothers with healthy children (p<0.05). Conclusion: The risk of attempted suicide was higher in mothers of children with CP than in those of healthy children. Accordingly, the observation of the psychological status of mothers with children with CP should be considered important. [ABSTRACT FROM AUTHOR]

This meta‐analysis examined concurrent associations between aggression, withdrawal, assertion, and prosocial behavior and each of positive and negative friendship quality across studies with 22,657 children and adolescents (Mage = 11.71 years; 51.7% girls; 67.7% White). Studies were published between 1995 to 2021 and 32.4% were conducted outside of North America. Aggression was linked to more negative, r¯ =.19, 95% CI [.14,.24], and less positive, r¯ = −.05 [−.08, −.01], friendships. Withdrawal was associated with less positive friendships, r¯ = −.13 [−.18, −.08], whereas prosocial behavior was related to more positive, r¯ =.29 [.22,.37], as well as less negative, r¯ = −.16 [−.20, −.12], friendships. Assertion was related to more positive friendships, r¯ =.15 [.01,.28]. [ABSTRACT FROM AUTHOR]

L'enfermement à domicile du jeune, qu'il soit associé ou non à un diagnostic psychiatrique, est un problème mondial qui reste longtemps invisible. Le phénomène est de mieux en mieux connu, entre autres à la faveur de la généralisation de la notion d'hikikomori. Cela désigne une conduite qui tend à se répéter, et qui finit par englober tous les membres de la famille autour des enjeux d'attachement et de séparation/individuation. C'est un auto-sabotage plutôt involontaire que choisi. Les symptômes psychiatriques qui y sont ou non associés ne peuvent rendre compte du retentissement majeur sur la qualité de vie du jeune et sur le fardeau ressenti par l'entourage. Le travail avec les familles discuté dans cet article témoigne d'une expérience clinique développée ces dernières années autour des consultations de familles dans une situation de hikikomori. Soulager le fardeau familial par des entretiens de guidance est au cœur de ce travail. Cela permet de se dégager de la culpabilité et de la honte, d'en finir avec les parents de l'enfance, et de sortir de l'isolement en faisant intervenir des tiers. Ces propositions sont discutées à la lumière des recherches provenant d'autres équipes, en majorité japonaises. Un réseau de professionnels s'est structuré avec l'association francophone AFHIKI pour réfléchir à l'adaptation de ces types de réponses à notre contexte culturel. Si des études sur les familles avec une situation de hikikomori existent depuis longtemps au Japon, elles commencent à voir le jour dans d'autres pays, notamment l'Espagne et l'Italie et mériteraient d'être mieux développées en France. Home confinement of a young person is a global problem whether or not it is associated with a psychiatric disorder. It is a maladaptive behavior that tends to repeat itself and finally involves the whole family in a shared difficulty of attachment/separation. Relieving the family burden using parental guidance could help to break the cercle vicious of guilt and shame among family members. Many studies on the features of families in hikikomori situations are cited in the article, mostly from Japanese authors. Constrained family culture, misunderstanding between the young person and his family, and dependency to parental figures are far more important today than in previous works where the poor quality of family relations were stressed. Studies about families in hikikomori situations are now beginning to emerge in non-Japanese countries, notably in Spain and Italy. It would be interesting to develop such research stream in France. This article also presents our clinical experience in responding to requests for consultations from families with a hikikomori situation, in developing a professional network via the AFHIKI association, and in animating a family exchange group about hikikomori. [ABSTRACT FROM AUTHOR]

Au début de sa vie d'adulte, Samuel Beckett présente certaines caractéristiques d'un retrait psychotique. Avant En attendant Godot qui va lui apporter la célébrité, la première pièce de théâtre qu'il compose entièrement s'intitule Eleutheria (« Liberté » en grec) et décrit la réclusion d'un adolescent au domicile de ses parents. Peut-être parce que trop proche de son intimité, l'auteur en refusera toujours la publication et la mise en scène. « Moins une action qu'un site, souvent vide », selon l'indication donnée en préambule par l'auteur, cette dramaturgie entretient d'évidence des liens substantiels avec la suite de l'œuvre. Pour comprendre celle-ci, beaucoup ont évoqué l'écriture du « néant » et ont présumé que Beckett aurait soigné une psychose, peut-être un autisme, par sa créativité. La connaissance de sa biographie pourrait orienter davantage vers le profil psychologique d'un état limite avec, à la fois, la menace d'un débordement d'excitation et l'appréhension forte du sentiment de vide si cette même excitation cesse de se faire sentir. Surtout, ses écrits et sa vie nous inspirent pour penser le monde contemporain et revoir les concepts de médiations thérapeutiques. Samuel Beckett, at the start of his adult life, had all the characteristics of a psychotic withdrawal. Before Waiting for Godot , which would bring him fame, the first play he composed entirely wad called Eleutheria ("Freedom" in Greek) and describes the confinement of a teenager at his parents' home. Perhaps because resembled too closely his own privacy, the author always refused publication and staging. "Less an action than a site, often empty", according to the indication given in the preamble by the author, this dramaturgy obviously has substantial links to the rest of the work. We criticize that to understand this many spoke of the writing of "exhaustion" and some assumed that Beckett would have treated a psychosis, perhaps an autism, by his creativity. Understanding of his biography could point more towards the psychological profile of a borderline state with, at the same time, the threat of an overflow of excitement and the strong apprehension of the feeling of emptiness if this same excitation ceases to be felt. Above all, his writings and his life have inspired us to think about the contemporary world and review the concepts of therapeutic mediation. [ABSTRACT FROM AUTHOR]

Psychiatric patients are often victims of crime and discrimination and are often socially withdrawn. This has negative consequences for their health and recovery. We examined whether such discrimination mediates the association between victimization and social withdrawal, and whether these associations differ between men and women. We also determined the prevalence of social withdrawal and the discrimination experienced by patients suffering from a severe mental illness. This study is embedded in the Victimization in Psychiatric Patients study. Information on discrimination, social withdrawal and victimization was obtained using structured self-report questionnaires (N = 949). We reported the 12-month prevalence of these phenomena and used path analysis to estimate the direct path between personal and property victimization and social withdrawal, and the indirect path through the discrimination experienced. The impact of gender was assessed by testing interaction terms. Social withdrawal was reported by 20.6% (95%CI 18.1–23.2) of participants, and being discriminated against in the past 12 months by 75.3% (95%CI: 72.6–78.0%). While crime victimization had no direct effects on social withdrawal, personal crime victimization (B = 0.47; 95%CI 0.25-0.72; p < 0.001) and property crime victimization (B = 0.65; 95%CI 0.42-0.93; p < 0.001) had significant indirect effects on social withdrawal, which were mediated by the discrimination experienced. In men we found a direct negative effect of property crime on social withdrawal (B = -0.68; 95%CI: −1.21to −0.11, p = 0.014). We conclude that personal and property victimization, for both men and women, was associated with higher levels of social withdrawal, and this was fully mediated by the discrimination experienced. • Social withdrawal is indirectly associated with victimization. • Discrimination mediates the effect between social withdrawal and victimization. • 75.3% of psychiatric patients perceived discrimination in the last 12 months. • 20.6% of psychiatric patients socially withdraw during the past 12 months. [ABSTRACT FROM AUTHOR]

The goal of this study is to explore normative beliefs about social withdrawal during adolescence. Participants were N = 419 adolescents (Mage = 16.13 years), who completed measures of normative beliefs about social withdrawal and their own social withdrawal (shyness, unsociability). Among the results, adolescents reported greater overall acceptance of unsociability compared to shyness, however, some gender differences also emerged. Specifically, adolescents were more accepting of unsociability when depicted by hypothetical females, and more accepting of shyness when depicted by hypothetical males. Participant social withdrawal was associated with greater acceptance of socially withdrawn behaviors in others. These findings provide a first look at normative beliefs about social withdrawal during a developmentally critical age period for this construct. [ABSTRACT FROM AUTHOR]

Using data from 832 kindergarten and first grade primary teachers and 662 of their students, the current study investigated teachers' use of behavioral and instructional classroom practices and whether these strategies moderated associations between teachers' expressions of positive and negative classroom emotion and students' social‐emotional and behavioral competence. Results indicated that teachers' positive expressiveness positively predicted young students' social competence and was inversely related to negative child outcomes, irrespective of teachers' behavioral and instructional classroom management practices. In contrast, teachers' negative emotional expressiveness positively predicted students' anger/aggression, but only when teachers reported using controlling and teacher‐centered approaches to classroom behavioral management. At the same time, teachers' negative expressiveness predicted low levels of student anger/aggression when teachers reported more child‐centered instructional management approaches. Findings contribute to the understanding of the intersection of teachers' expressiveness and their classroom management practices for explaining children's social‐emotional and behavioral competence in early childhood classrooms. RESEARCH HIGHLIGHTS: ‐Teachers' positive expression of emotions was linked to high levels of cooperative/sensitive child behavior and negatively related to students' anger/aggression and anxious/withdrawal behavior.‐Teachers' negative emotional expression was negatively associated with students' anxious/withdrawal behavior‐There was lack of association between teachers' emotional expressiveness and their classroom management practices.‐Teachers' negative expressiveness positively predicted students' anger/aggression, but only when teachers reported a controlling approach to classroom behavioral and instructional management. [ABSTRACT FROM AUTHOR]

We analyzed the courses of experience of 10 runners who volunteered to describe their experiences of withdrawal during an ultra-trail race. Data collected contained traces of past activities elicited in self-confrontation interviews. Data were coded and compared with identify structures in common sequences. Seven representative sequences were identified: feeling pain; putting meaning to those feelings; adjusting one's running style; attempting to overcome the problem; other runners' influences; assessing the situation; and deciding to withdraw. Results showed that disruptive events could cause progressive, cumulative, and varied transformations in runners' courses of experience that led inevitably to withdrawal. Practical implications for mental preparation and race management are proposed. [ABSTRACT FROM AUTHOR]

Adolescents with rare genetic disorders represent a population that can be at risk in psychosocial terms. Despite its importance, the association of autism traits and social withdrawal in behavioral and emotional problems in adolescents with rare genetic disorders remains understudied. The study aimed to empirically examine the clinical characteristics of adolescents with rare genetic disorders with a behavior theory-driven approach. We investigated the behavioral and emotional problems and current and lifetime autistic traits in a sample of 93 Norwegian adolescents (M age = 13.2 years, SD age = 2.4, range age 10–17, 62.4% females, 37.6% males) with various rare genetic disorders. The adolescents were investigated cross-sectionally utilizing standardized psychometric questionnaires rated by their parents. More current and lifetime autistic traits and social withdrawal were all associated with more internalizing problems. Further analyses demonstrated that social withdrawal partially mediated the positive association between current autistic traits and internalizing problems. In contrast, social withdrawal fully mediated the positive association between lifetime autistic traits and internalizing problems. Our results demonstrate important characteristics of adolescents with rare genetic disorders that may guide clinicians and future interventions. Social withdrawal may be prodromal to internalizing problems such as anxiety and depression. Thus, clinically addressing social withdrawal can represent a means to prevent internalizing problems in adolescents with rare genetic disorders and autistic traits. • Adolescents with rare disorders represent a population that may be particularly socially vulnerable. • Social withdrawal and autistic traits are important unmet needs of adolescents with rare diseases. • Social withdrawal is a pivotal mediator between autism traits and internalizing problems in adolescents with rare diseases. • Behavioral interventions should address social withdrawal to avert escalating internalizing problems. [ABSTRACT FROM AUTHOR]

We have investigated the effect of the intranasal degydroepiandrosterone (DHEA) treatment on the emotional status and zoosocial behavior of rats during ethanol withdrawal compared to the level of voluntary ethanol consumption and its preference at the 2-bottle test. It was shown that under conditions of renewal of alcohol access, the highest decrease in the intensity of its usage (by 75%), as compared to controls, was found in all experimental animals. Additionally, DHEA has promoted significant reduction (by 72%) in the pathological addiction to ethanol. These results, combined with the restoration of zoosocial relationships with the predominance of the socio-centric type, have reflected the normalizing effect of neurosteroids on the emotional behavior of the alcoholized animals, which suggest certain therapeutic potential of DHEA directed to a decrease in the level of ethanol addiction. [ABSTRACT FROM AUTHOR]

• Examined IL-6 changes to influenza vaccine and target-specific social behavior. • IL-6 increases associated with increased accuracy withdrawing from strangers. • Increases in IL-6 were associated with decreased accuracy approaching strangers. • IL-6 increases associated with decreased reaction time to approach a close other. • There was no association between IL-6 and withdrawal from a close other. Recent evidence suggests differential patterns of social behavior following an inflammatory challenge, such that increases in inflammation may not uniformly lead to social withdrawal. Indeed, increases in inflammation have been associated with enhanced self-reported motivation to approach a specific close other, and greater neural sensitivity to positive social cues. However, no known studies have examined the association between inflammation in response to an inflammatory challenge and social behavior in humans, nor has past research examined specifically how approach and withdrawal behavior may differ based on whether the target is a close other or stranger. To address this, 31 participants (ages 18–24) received the influenza vaccine to elicit a low-grade inflammatory response. The morning before and approximately 24 h after the vaccine, participants provided a blood sample and completed a computer task assessing automatic (implicit) approach and withdrawal behavior toward a social support figure and strangers. Greater increases in the inflammatory cytokine interleukin-6 (IL-6) in response to the vaccine were associated with an increase in accuracy in avoiding strangers and a decrease in accuracy in approaching them. Increases in IL-6 were also associated with a decrease in reaction time to approach a support figure, but only when controlling for baseline IL-6 levels. There were no associations between change in IL-6 and changes in self-reported motivation to engage in social behavior with either close others, or strangers. Together, these findings reveal that increases in inflammation following the influenza vaccine are associated with automatic social behavior, especially behavior suggesting avoidance of unfamiliar social targets and ease in approaching a support figure. These data add to the growing literature suggesting that the association between inflammation and social behavior includes both social withdrawal and social approach, depending on the specific target. [ABSTRACT FROM AUTHOR]

The saying "mental illness is like any other illness" has increasingly become pervasive in promoting mental health literacy among the public in China. This discourse is based on the fact that mental illness is attributed to primarily biogenetic causes. This study comprises an investigation of the impact of causal attributions of mental illness on the social withdrawal inclination of people with chronic mental illnesses (PCMIs) in China. Drawing on attribution theory and a sample of PCMIs, the current authors further question the effectiveness of biogenetic discourse to combat social stigma and to integrate PCMIs into society. In addition, in response to the proliferation of discussion on the digital inclusion of those with mental disabilities, this study constructs a structural model in which the varied effects of supportive communication are used as bridging factors, including face-to-face, telephonic and social media communication. The results indicate a stronger social withdrawal inclination when the PCMIs attributed their illnesses to biogenetic causes. In addition, biogenetic attribution was also found to potentially hinder the PCMIs from using the telephone and social media to seek supportive communication, while psychosocial attribution was found to have potential to combat PCMIs' social withdrawal inclination. In this vein, this study calls for further investigation on the conditional factors upon which digital inclusion might work for PCMIs in China. [ABSTRACT FROM AUTHOR]

Background: Epilepsy's psychological effects are variable, some may experience a few mental health issues while some may experience serious problems like anxiety, depression, ADHD, mood disorders etc.hence there is a need to screen these problems at an early age for timely intervention. So our study was conducted to determine the prevalence of emotional and behavioral problems in children with epilepsy. Methods: The overall prevalence of emotional and behavioral problems in childhood was determined by calculating the percentage of children with child behaviour checklist score indicative of specific emotional and behavioral problems. Prevalence for specific morbidities were also calculated and reported separately for each condition. Results were presented in form of tables, charts, graphs and narratives. Results: The overall prevalence of emotional and behavioural problems in children was 38.7%. Attention problem (13.5%), aggressive behaviour (10.8%), social problems (8.1%) and withdrawal/depression (6.3%) were the four leading syndromes The prevalence of emotional and behavioural problems was significantly associated with age of onset of epilepsy, type of epilepsy, frequency of seizures, antiepileptic drug therapy used by child. Conclusion: As there is higher prevalence of emotional and behavioral problems in children with epilepsy, age of onset, frequency of seizure and duration of diseases were found to be significantly associated with occurrence of behavioural problems, therefore prompt and early screening for these problems, as well as integrated management consisting of pharmacotherapy, behavioural modification, parental education and counselling, psychotherapy and psychoeducation would help to reduce their effect in these patients. [ABSTRACT FROM AUTHOR]

In low- and middle-income countries, there is a high prevalence of post-partum depression and it is often associated with HIV status. Maternal depression negatively affects mothering and can lead to social withdrawal in infants. Maternal depression and infant social withdrawal can have deleterious long-term effects on children's behaviour and neurodevelopmental trajectories. To investigate whether maternal depression and infant social withdrawal at 10–12 months post-partum were significant predictors of child behaviour and development at 42 months. Seventy-four mother–infant dyads living with HIV were followed in a prospective, longitudinal design. Mothers were assessed for depression using the Center for Epidemiologic Studies Depression scale (CES-D). Infant social withdrawal was assessed by the modified Alarm Distress Baby Scale (m-ADBB), and development and behaviour were evaluated by the Griffiths Mental Development Scales (GMDS) and the Child Behavior Checklist (CBCL), respectively. Maternal depression explained 4.8% of the variance in child behaviour (β = 0.98, t = 2.05, p < 0.05) and 10.3% of the variance in development (β = −0.30, t = −2.66, p < 0.05). Infant social withdrawal was not a significant predictor of behaviour (β = 3.27, t = 1.36, p = 0.18), but it did uniquely explain 7% of the variance in development (β = −1.32, t = −2.48, p < 0.05). In the context of HIV, screening for maternal depression and the quality of mother–infant interactions are important (especially in the 1st year post-partum), given the significant long-term impact they have on behaviour and neurodevelopment. ANOVA: analysis of variance; ART: antiretroviral therapy; CBCL: Child Behavioral Checklist; CES-D: Center for Epidemiologic Studies Depression Scale; CHEI: children HIV-exposed and infected; CHER: Children with HIV Early Antiretroviral Treatment Trial; CHEU: children HIV-exposed and uninfected; CHUU: children HIV-unexposed and -uninfected; GMDS: Griffiths Mental Development Scales; HIV: human immunodeficiency virus; LMIC: low- and middle-income countries; m-ADBB: modified Alarm Distress Baby Scale; NRF: National Research Foundation; SAMRC: South African Medical Research Council; WHO: World Health Organization [ABSTRACT FROM AUTHOR]

Objective: Adopted children tend to show an increased risk for a variety of psychopathological outcomes, even when adoption occurs at birth, which some suggest is a result of nonrandom assignment of adoptees and parents. This study uses a nonhuman primate model, in which adoptions were randomly assigned, to investigate the behavioral and physiological outcomes associated with at-birth adoption.Method: Immediately following birth, rhesus monkey infants were randomly assigned to be reared by either their biological mother (n = 113) or by an unrelated, lactating, adoptive mother (n = 34). At 6 months of age, infant behavior and physiology were assessed during a stressful series of mother-infant separations. Four years later, stress-related behaviors were measured following confrontation by an unfamiliar intruder, an ecologically meaningful stressor.Results: When compared to infants reared by their biological mothers, adopted infants exhibited more behavioral withdrawal and higher plasma adrenocorticotropic hormone (ACTH) concentrations in response to separation. These behavioral differences persisted 4 years later during a stressful intruder challenge, with adoptees exhibiting more behavioral withdrawal, stereotypies, and impulsive approaches of the potentially aggressive intruder.Conclusion: Compared to infants reared by their biological mothers, adopted infants exhibited more behavioral inhibition, impulsivity, and higher ACTH concentrations, even when subjects were randomly assigned to be adopted or to remain with their biological mother. To the extent that these findings generalize to humans, they suggest that the overall risk for psychopathology in adopted individuals persists even after random assignment to adoption conditions. [ABSTRACT FROM AUTHOR]

The current study aimed to identify patterns of situation selection and modification behaviors using a person-centered approach, and to examine to what extent the trait social inhibition (SI) is associated with these patterns of situation-targeted emotion regulation. The sample comprised 504 participants (Mage = 21.5, SD = 8.2; 82% women), who completed questionnaires on situation selection and modification behaviors, and the social inhibition questionnaire (SIQ15). A three-step latent profile analysis (LPA) was performed to (A) identify existing latent profiles of situation avoidance and approach and situation modification behaviors, and (B) to examine the association of SI and facets with the latent class posteriors. LPA revealed the presence of four profiles that differed in how situation selection and modification were applied. SI, behavioral inhibition, and social withdrawal were significantly associated with a higher odds of belonging to the profile characterized by avoidance selection and modification. Interpersonal sensitivity was associated with using more conversational modification behaviors, which may illustrate that interpersonal sensitive individuals are motivated to approach, but use avoidance behaviors to prevent confrontation. SI individuals particularly rely on avoidance selection and modification behaviors, which may be considered maladaptive emotion regulation. [ABSTRACT FROM AUTHOR]

In this article, we provide definitional clarity for the construct of social withdrawal as it was originally construed, and review the original theoretical and conceptual bases that led to the first research program dedicated to the developmental study of social withdrawal (the Waterloo Longitudinal Project). We also describe correlates (e.g., social and social‐cognitive incompetence), precursors (e.g., dispositional characteristics, parenting, insecure attachment), and consequences (e.g., peer rejection and victimization, negative self‐regard, anxiety) of social withdrawal, and discuss how the study of this type of withdrawal led to a novel intervention that targets risk factors that predict social withdrawal and its negative consequences. [ABSTRACT FROM AUTHOR]

Involvement in romantic relationships is a salient developmental task in late adolescence and early adulthood, and deviations from normative romantic development are linked to adverse outcomes. This study investigated to what extent social withdrawal contributed to deviations from normative romantic development, and vice versa, and the interplay between withdrawal and couples' relationship perceptions. The sample included 1710 young adults (55–61% female) from the Tracking Adolescents' Individual Lives Survey cohort and their romantic partners. Data were collected across 4 waves, covering romantic relationships from ages 17 to 29 years. The results showed that higher withdrawal predicted a higher likelihood of romantic non-involvement by adulthood, consistently being single at subsequent waves, and entering one's first relationship when older. Withdrawal moderately decreased when youth entered their first relationship. Male's withdrawal in particular affected romantic relationship qualities and dynamics. These results provide new insights into the developmental sequelae of withdrawn young adults' romantic relationship development. [ABSTRACT FROM AUTHOR]

Maternal gestational inflammation from infection, obesity, depression, and adverse childhood experiences negatively affects offspring cognitive development. Choline is a key nutrient in fetal brain development. We investigated whether higher maternal plasma choline concentrations have a positive association with offspring cognition, specifically processing speed, in the presence of inflammation. Forty-eight children were evaluated at 4 years of age. Processing Speed Composite Score on the Wechsler Preschool & Primary Scales of Intelligence was the principal outcome. Maternal C-reactive protein (CRP), a marker of inflammation, and choline plasma concentration had been measured at 16 weeks' gestation. Choline concentrations >7.07μM were compared to lower levels. Mothers with lower choline levels reported more depression and stress. Head circumference was larger for neonates of mothers with higher choline levels. In analyses with maternal CRP, higher maternal choline was associated with higher offspring Processing Speed Composite Scores for both sexes. For males, higher maternal choline competed with the negative association of maternal CRP on Processing Speed. Higher Processing Speed was related to the child's behavioral ratings, with fewer Withdrawn Problems on the Child Behavior Checklist 1 ½-5 years at 4 years and higher Infant Behavior Questionnaire Orienting/Regulation at 3 months of age, consistent with persistent developmental effects. Higher processing speed and decreased problems in social withdrawal are positively associated with prenatal maternal choline. Both lower processing speed and social withdrawal problems are precursors to later mental difficulties. Choline supplementation in pregnancy may mitigate effects of maternal inflammation that contribute to problems in offspring's' cognition and behavior. • Maternal inflammation during gestation is associated with decreased development of cognition in the offspring. •The competing beneficial effects of choline with the adverse effects of inflammation are observed at 4 years of age with the Processing Speed Component of the Wechsler Preschool and Primary Scale of Intelligence – IV. •Many women have suboptimal choline concentrations; recommended choline supplements can raise levels and thereby promote fetal brain development and enhanced cognitive capability, even in the presence of maternal inflammation. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study is to compare social competence skills in children with CI and their normal hearing peers. Methods: Forty-six children with normal hearing and 46 children with CI between the ages of 42 and 72 months were included in the control group and study group, respectively. Preschool teachers rated children's social competence in the classroom using the Social Competence and Behavior Evaluation—Preschool Edition. Three subscales constitute the structure of the SCBE-30 scale: anger-aggression, social competence, and anxiety-withdrawal. Results: The analyses showed that there were statistically significant differences between social competence scores of the study group and the control group. However, there was no statistically significant difference between anger-aggression scores and anxiety-withdrawal scores of the study group and the control group. There was a significant correlation found between anger-aggression score and the age of starting rehabilitation. Conclusion: Anger-aggression scores and anxiety-withdrawal scores were similar between children using cochlear implant and normal hearing peers, whereas children with CI show lower social competence abilities than normal hearing peers. Earlier beginning to the rehabilitation programs coincide with lower anger-aggression scores. To the best of our knowledge, this is the first study to reflect these findings more objectively, from the view of teachers. [ABSTRACT FROM AUTHOR]

Withdrawn behavior is present in many psychological problems and it is often used interchangeably with other psychological constructs, making accurate classification difficult. In an effort to better understand the classification and developmental course of withdrawn behavior in youth, the current study used parent-report to assess 649 Dutch youth at three time points across eight years, using the Withdrawn/Depressed (W/D) scale of the Child Behavior Checklist (CBCL). Mean age of participants at each time point are 7.52 (Wave 1), 11.77 (Wave 2), and 15.53 (Wave 3) years. Latent class analysis and latent transition analysis was employed to empirically derive distinct subclasses of withdrawn youth and to examine how these youth transition between classes over time. Most youth fell within a low symptom class (Time 1 = 79.4%, Time 2 = 79.2%, Time 3 = 68.5%). A shy/secretive class also emerged (Time 1 = 20.6%, Time 2 = 20.8%, Time 3 = 31.5%). For girls, the interpretation of the shy/secretive class changed at Time 3 (e.g., ages 14–17 years), such that the majority of girls in this class also exhibited depressed mood. The majority of youth remained in the same class over time. This study used a model-based person-centered approach to derive classes of withdrawn behavior over time. The W/D subscale could be used as a brief screening tool for early detection of the shy/secretive behavioral phenotype, which may be a risk factor for later psychopathology. It is recommended that future studies identify predictors of class transition and investigate whether withdrawn classes predict diagnostic outcome. Highlights: This study was the first latent class and transition analysis of the CBCL W/D scale. A low symptom withdrawn class and shy/secretive withdrawn class emerged. For adolescent girls, the shy/secretive class included elevated depressed mood. Most youth remained in the same withdrawn class over time. This study used a model-based person-centered approach to study youth withdrawn behavior. [ABSTRACT FROM AUTHOR]

Mental disorders are complex, multifaceted phenomena that are associated with profound heterogeneity and comorbidity. Despite the heterogeneity of mental disorders, most are generally considered unitary dimensions. We argue that certain measurement practices, especially using too few indicators per construct, preclude the detection of meaningful multidimensionality. We demonstrate the implications of crude measurement for detecting construct multidimensionality with alcohol use disorder (AUD). To do so, we used a large sample of college heavy drinkers (N = 909) for whom AUD symptomology was thoroughly assessed (87 items) and a blend of confirmatory factor analysis, exploratory factor analysis, and hierarchical clustering. A unidimensional AUD model with one item per symptom criterion fit the data well, whereas a unidimensional model with all items fit the data poorly. Starting with an 11-item AUD model, model fit decreased and the variability in factor loadings increased as additional items were added to the model. Additionally, multidimensional models outperformed unidimensional ones in terms of variance explained in theoretically relevant external criteria. All told, we converged on a hierarchically organized model of AUD with three broad, transcriterial dimensions that reflected tolerance, withdrawal, and loss of control. In addition to introducing a hierarchical model of AUD, we propose that thorough assessment of psychological constructs paired with serious consideration of alternative, multidimensional structures can move past the deadlock of their unidimensional representations. (PsycInfo Database Record (c) 2021 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Affecting approximately 9.4% of the population worldwide, acne vulgaris is a common chronic inflammatory skin disease. Medical students are exposed to higher levels of stress and have a higher prevalence of acne. However, the risk factors and the impact of acne on medical students' mental health remains poorly understood. The aim of this literature review is to: (i) summarize the prevalence and risk factors of acne vulgaris in medical students and (ii) highlight the impact of psychological consequences of acne in medical students. A literature search was conducted using MEDLINE and EMBASE in OVID, using variations in the following search terms: acne vulgaris, medical students, self‐esteem, psychology, psychiatry, suicide, suicidal thoughts, self‐harm, positive and negative effects, psychological well‐being, anxiety, and depression. Studies that stated the prevalence or risk factors of acne vulgaris and/or examined the association between psychosocial effects and acne vulgaris in medical students were included. Eleven cross‐sectional studies were included. The prevalence of acne vulgaris in medical students ranged from 34.38% to 97.9% across nine studies. Review of these articles revealed that acne prevalence is associated with stress, gender differences, and lifestyle factors in medical students. Acne had many negative psychological and social impacts on medical students including negative self‐image, lower confidence, embarrassment, depression, anxiety, social withdrawal, and impaired social behaviors. Further research on the intersection between acne vulgaris and the mental health of medical students is needed. [ABSTRACT FROM AUTHOR]

We investigated how covert narcissism influences depression through shame-focused coping strategies, and tested the moderating effect of self-compassion in this mediating link. Participants were 316 Chinese international students living in South Korea who completed a battery of measures, including the Hypersensitive Narcissism Scale, the Compass of Shame Scale, the depression items of the Symptom Checklist-90-Revised, and the Chinese Self-Compassion Scale. We found an association between covert narcissism and depression, and this link was mediated by the shame-focused coping strategies of attack self and withdrawal. Further, self-compassion had a significant moderating effect in the relationship between covert narcissism and the coping strategies of attack self or withdrawal. These findings support a moderated mediation model in which self-compassion buffered the relationship between covert narcissism and depression by mediating the link between covert narcissism and the attack self and withdrawal coping strategies. Our findings may be useful for understanding and helping individuals who have a high level of covert narcissism. [ABSTRACT FROM AUTHOR]

Adolescents were a particularly vulnerable group at the time of the pandemic. Restrictions applied during quarantine brought a lot of stress and challenges for the youth. The aim of this study was to reveal how adolescents cope with challenges faced during the lockdown due to COVID-19. Twenty four 13–17-year-old adolescents participated in a qualitative study using semi-structured in-depth interviews via Zoom. Findings revealed seven themes related to youth coping behavior during lockdown: 1. withdrawal behavior, 2. focus on particular activities, 3. social support seeking within family and via the internet with friends, 4. expression of overwhelming emotions, 5. protest against quarantine restrictions, 6. attempts to maintain “active oneself”, 7. search for the personal meaning of the lockdown. Understanding the coping behaviors and helping adolescents reflect their mental states in stressful situations could be effective interventions in order to reduce the risk of future psychological problems. [ABSTRACT FROM AUTHOR]

When prolonged social withdrawal was first described in Japan as 'hikikomori', many studies examining its etiology suggested it to be related to factors unique to Japan and thus a culture-bound syndrome. However, existing research has suffered from a lack of standardised definitions, impeding comparability between studies. We summarise existing research and discuss its relevance to psychiatric practice today. [ABSTRACT FROM AUTHOR]

Adolescence is a period of heightened emotionality, and difficulties with emotion regulation during adolescence are associated with the development of internalizing disorders, especially for girls, who are at elevated risk. Mothers may socialize emotion dysregulation by engaging in frequent interactions with their adolescents that involve mutual increases in arousal. This study tested a model of mother-adolescent mutual arousal escalation in a conflict discussion task in adolescent girls and examined associations between mutual arousal escalation and adolescent emotion regulation. Participants were 97 adolescent girls (Mage = 12.29[0.81]; 69% White) and their biological mothers. Dyads completed a 5 m conflict discussion task; skin conductance level was collected to measure arousal. Adolescent emotion regulation outcomes were assessed using multiple methods, including arousal habituation to a laboratory-based social stressor and self-reported rumination and problem-solving. Multilevel models provided evidence that mother-adolescent dyads vary in the degree to which they mutually escalate or de-escalate arousal during a conflict discussion and in the degree to which mothers "transmit" arousal to adolescents. For dyads high in either mutual arousal escalation or de-escalation, adolescents reported higher rumination. These findings provide evidence for transactional models of emotion socialization and suggest that adolescents in dyads who mutually escalate or de-escalate in arousal report more rumination, which may be indicative of a practiced dysregulatory response in stressful contexts (escalation) or a tendency toward cognitive processes that lead to withdrawal from aversive environments (de-escalation). [ABSTRACT FROM AUTHOR]

Social withdrawal is an early and common feature of psychiatric disorders. Hypothalamic-pituitary-adrenal (HPA)-axis activation through increased salivary cortisol (sC) and sympathetic activation through increased salivary alpha-amylase (sAA) may play a role. We aimed to study whether the link between increased sC and sAA on the one hand and depression on the other hand is mediated by social withdrawal. In this cross-sectional, observational study, sC and sAA measures were measured in seven saliva samples in 843 participants (231 psychiatric patients and 612 healthy controls). Social withdrawal was assessed through the Brief Symptom Inventory (BSI)-, the Short Form 36-, and the Dutch Dimensional Assessment of Personality Pathology social withdrawal subscales, and analyzed using linear regression and mediation analyses. On average, participants were 44.0 years old (SD = 12.8; 64.1% female). Basal and diurnal sAA were unrelated to any social withdrawal scale and depression. Certain sC measures were positively associated with the BSI social withdrawal subscale (i.e., area under the curve with respect to the increase, beta = 0.082, p = 0.02; evening sC value: beta = 0.110, p = 0.003; and mean sC value: beta = 0.097; p = 0.01). We found limited support for statistical mediation by social withdrawal (measured using a composite social withdrawal score) on the relationship between evening sC and depression. Thus, although we found no support for a role of basal and diurnal sAA in social withdrawal, HPA-axis activation may partly aggravate social withdrawal in depressive disorders. • Basal and diurnal salivary alpha-amylase levels were not associated with social withdrawal. • Social withdrawal did not mediate the relationship between basal and diurnal salivary alpha-amylase and depression. • Activation of the HPA-axis may be one of the biological pathways that induces social withdrawal in depressive disorders. [ABSTRACT FROM AUTHOR]

Abstract: The nucleus accumbens (NAc) and the ventral tegmental area (VTA) are critical hubs in the brain circuitry controlling chronic pain. Yet, how these 2 regions interact to shape the chronic pain state is poorly understood. Our studies show that in mice, spared nerve injury (SNI) induced alterations in the functional connectome of D2-receptor expressing spiny projection neurons in the core region of the NAc-enhancing connections with prelimbic cortex and weakening them with basolateral amygdala. These changes, which were attributable in part to SNI-induced suppression of VTA dopaminergic signaling, were adaptive because mimicking them chemogenetically alleviated the anxiety and social withdrawal accompanying injury. By contrast, chemogenetic enhancement of activity in VTA dopaminergic neurons projecting to the medial shell of the NAc selectively suppressed tactile allodynia in SNI mice. These results suggest that SNI induces regionally specific alterations in VTA dopaminergic signaling in the NAc to promote environmental reengagement after injury. However, countervailing, homeostatic mechanisms limit these adaptive changes, potentially leading to the chronic pain state. [ABSTRACT FROM AUTHOR]

SUMMARY: Smoking rates in people with depression and anxiety are twice as high as in the general population, even though people with depression and anxiety are motivated to stop smoking. Most healthcare professionals are aware that stopping smoking is one of the greatest changes that people can make to improve their health. However, smoking cessation can be a difficult topic to raise. Evidence suggests that smoking may cause some mental health problems, and that the tobacco withdrawal cycle partly contributes to worse mental health. By stopping smoking, a person's mental health may improve, and the size of this improvement might be equal to taking antidepressants. In this article we outline ways in which healthcare professionals can compassionately and respectfully raise the topic of smoking to encourage smoking cessation. We draw on evidence-based methods such as cognitive–behavioural therapy (CBT) and outline approaches that healthcare professionals can use to integrate these methods into routine care to help their patients stop smoking. [ABSTRACT FROM AUTHOR]

Purpose: Depression and anxiety have been extensively associated with adverse outcomes in coronary heart disease patients. However, psychological and physiological processes underlying the persistence of these troubles in coronary heart disease patients attending cardiac rehabilitation are poorly investigated. Trait emotional competencies and heart rate variability could be some of these processes. Thus, the aim of this study was to assess the predictive value of trait emotional competencies and heart rate variability on depression and anxiety symptoms persistence in coronary heart disease patients. Methods: Eighty-four patients who recently presented a myocardial infarction were evaluated at the beginning of cardiac rehabilitation. Forty-two patients continued their rehabilitation program and were then assessed three months later. They completed the Profile of Emotional Competence as well as the Hospital Anxiety and Depression Scale and underwent a 5-minute resting heart rate variability measure. Results: Low trait emotional competencies score predicted depression symptoms persistence, but unexpectedly, high trait emotional competencies score was also associated with withdrawal from cardiac rehabilitation. Contrary to our expectations, heart rate variability did not predict depression or anxiety symptoms persistence and was not associated with trait emotional competencies. Conclusions: This study is the first to report an association between trait emotional competencies and depression symptoms persistence in coronary heart disease patients. However, heart rate variability was not associated with either depression or anxiety supporting the idea of mixed literature and highlighting the need of future research. [ABSTRACT FROM AUTHOR]

Identifying early risk factors for the development of social anxiety symptoms has important translational implications. Accurately identifying which children are at the highest risk is of critical importance, especially if we can identify risk early in development. We examined continued risk for social anxiety symptoms at the transition to adolescence in a community sample of children (n = 112) that had been observed for high fearfulness at age 2 and tracked for social anxiety symptoms from preschool through age 6. In our previous studies, we found that a pattern of dysregulated fear (DF), characterized by high fear in low threat contexts, predicted social anxiety symptoms at ages 3, 4, 5, and 6 years across two samples. In the current study, we re-evaluated these children at 11–13 years of age by using parent and child reports of social anxiety symptoms, parental monitoring, and peer relationship quality. The scores for DF uniquely predicted adolescents' social anxiety symptoms beyond the prediction that was made by more proximal measures of behavioral (e.g., kindergarten social withdrawal) and concurrent environmental risk factors (e.g., parental monitoring, peer relationships). Implications for early detection, prevention, and intervention are discussed. [ABSTRACT FROM AUTHOR]

Hikikomori refers to a state of pathological social withdrawal combined with avoidance of major social interactions or responsibilities. The present study examined the associations that aspects of hikikomori had with thwarted belongingness and perceived burdensomeness as well as whether culture moderated these associations in participants from the United States (n = 276) and Japan (n = 250). Results showed that avoidance of socialization and lack of emotional support were positively associated with both thwarted belongingness and perceived burdensomeness. Furthermore, the association between avoidance of socialization and perceived burdensomeness was stronger for Japanese participants than for those from the United States. These findings suggest that psychological mechanisms contributing to suicidal thoughts during limited physical contact and isolation may be linked to psychological and social withdrawal. • Hikikomori is a state of pathological social withdrawal. • We analyzed data from the US and Japan. • It was related with thwarted belongingness and perceived burdensomeness. • The association between hikikomori and burdensomeness was stronger for Japanese. [ABSTRACT FROM AUTHOR]